However, about 66 caregivers using the services were assured they would be continued after PACE, the Program of All-Inclusive Care for the Elderly, was closed down at the hospital last June, he said.

If the remaining services are stopped, he said, it will be the second time in a year the corporation's Oahu board "will shut down a program serving the most vulnerable kupuna." His mother might have to go into a nursing home if this happens, he said.

Crystal Ching, the primary caregiver for her 85-year-old grandmother, also said one reason her grandmother is not in a nursing home is the help she gets from the geriatric physician and nurse at Maluhia.

"We're anticipating a viable solution," said health system spokesman Miles Takaaze. "Our message is to give us a chance to work with each of the clients and family members."

The Oahu board, chaired by University of Hawaii professor William Wood, will meet at 5 p.m. Tuesday at Maluhia Hospital. The meeting is open to the public, and the caregivers will have an opportunity to speak.

Feldman said PACE "was just a wonderful, wonderful program, used with great success on the mainland. ... I don't know why they were unable to make it a success at Maluhia Hospital."

Takaaze said the Legislature approved PACE as a demonstration project and that it ran as a "pre-PACE" program for 10 years. Because of low Medicaid reimbursements, however, the program had consistent losses, up to $1 million in one year, he said.

Ken Takeuchi, who was interim manager of PACE for about two years, said it was a good program but that it was unable to meet a lot of federal regulations, such as for staff credentialing and electronic data.

Part of the problem is that it was being operated by a state agency, and those on the mainland are run by private nonprofit organizations, he said.

Feldman said loss of the physician and home care services would be "a real body blow. ... We were so blessed to have this physicians' service here. For them to take it away from us, we're incredulous. It doesn't make sense."